| NPI | 1760452486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2014-01916) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL 21055) |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2025-11-13 |